Provider Demographics
NPI:1326274655
Name:VICTORY MEDICAL EQUIPMENT AND SUPPLIES, INC.
Entity Type:Organization
Organization Name:VICTORY MEDICAL EQUIPMENT AND SUPPLIES, INC.
Other - Org Name:N/A
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:OLALEKAN
Authorized Official - Middle Name:OLAWOLE
Authorized Official - Last Name:OLOWOOKERE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-794-8885
Mailing Address - Street 1:6099 MT MORIAH RD EXT
Mailing Address - Street 2:SUITE 32
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38115-0313
Mailing Address - Country:US
Mailing Address - Phone:901-794-8885
Mailing Address - Fax:901-794-8884
Practice Address - Street 1:6099 MT MORIAH RD EXT
Practice Address - Street 2:SUITE 32
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38115-0313
Practice Address - Country:US
Practice Address - Phone:901-794-8885
Practice Address - Fax:901-794-8884
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-01
Last Update Date:2009-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies